| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,689 |
1,604 |
$132K |
| 92250 |
|
2,370 |
2,258 |
$105K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,922 |
1,834 |
$104K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
2,285 |
2,229 |
$100K |
| 92083 |
|
2,290 |
2,182 |
$83K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
778 |
747 |
$74K |
| 76512 |
|
1,883 |
1,796 |
$54K |
| 92133 |
|
1,738 |
1,673 |
$44K |
| 92020 |
|
2,393 |
2,279 |
$39K |
| 92015 |
Determination of refractive state |
2,065 |
1,983 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,058 |
1,048 |
$24K |
| V2020 |
Frames, purchases |
1,132 |
1,124 |
$19K |
| 76514 |
|
827 |
804 |
$6K |
| 92025 |
|
108 |
104 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
65 |
65 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
198 |
194 |
$1K |
| 92136 |
|
17 |
12 |
$709.34 |